NHS Key Publications - July 2023
Introduction
MIAA is a member of the Internal Audit Network (TIAN) which comprises the eight NHS internal audit consortiums and in house teams operating in England. These organisations collaborate across a number of areas to leverage their collective knowledge and expertise and drive efficiency and effectiveness. The monthly insight report highlights key publications and is intended as a useful update and reference tool. This report is produced by TIAN and shared by MIAA.
HFMA summary of the NHS long term workforce plan
NHS England published the NHS long term workforce plan (the plan) on 30 June 2023. This is a long-awaited document which looks to ensure the NHS has the workforce it needs for the future. NHS England described it as ‘a once-in-a-generation opportunity to put staffing on a sustainable footing and improve patient care’, this being the first time that the government has asked the NHS to come up with a comprehensive workforce plan. NHS England has committed to updating this plan at least every two years. This will help to mitigate uncertainty in the forecasting assumptions and will mean that NHS England can react and respond to any under- or over- performance against targets.
This briefing summarises NHS England’s plan, giving an overview of the key messages before focusing in on some of the financial implications. Please refer to the full plan for more detail. It can be found here.
For information
CQC issues its public engagement strategy
The CQC’s Public Engagement Strategy sets out how they plan to engage with people who use services, their families and unpaid carers, and organisations who represent them throughout our work.
The new strategy supports the CQC organisational strategy published in 2021 and sets out how they will listen, inform and involve people and work in partnership with the organisations that represent people.
It can be found here.
For information
Annual assessment of integrated care boards 2022-23: supporting guidance (NHSE)
This guidance details the areas that the annual assessment for 2022/23 will cover, as well as information on timing and process. It should be read in conjunction with other key planning and oversight documents including the NHS Long Term Plan, the NHS Oversight Framework and the 2022/23 priorities and operational planning guidance.
For information and action by ICBs
Government response to the HSCC report and the Hewitt Review on integrated care systems
The Health and Social Care Committee (HSCC) launched their inquiry on integrated care systems (ICSs) on 6 July 2022 and published their Seventh report - Integrated care systems: autonomy and accountability on 30 March 2023.
The government also commissioned an independent review of ICSs in November2022 which was led by Rt Hon Patricia Hewitt. The review published its findings on 4 April 2023.
Both the HSCC report and the Hewitt Review share a similar focus, with overlapping themes such as:
⦁ targets and priorities for ICSs
⦁ autonomy and support for ICSs
⦁ ICS governance, accountability and oversight
⦁ assessment and review of ICSs
⦁ prevention and promoting health
⦁ finance and funding
The Hewitt Review also considered additional themes of:
⦁ data and digital
⦁ primary and social care
The government considered both the reports and has produced a combined response. Read here.
For information
All is not well: sickness absence in the NHS in England (Nuffield Trust briefing)
In this briefing, the Nuffield Trust reports that:
⦁ Monthly sickness absence rates over the last calendar year never once fell below even the peak in the pre-pandemic year and, on average, the reported rate for NHS staff across 2022 was 29% higher than in 2019 (5.6% v 4.3%).
⦁ The reported level of sickness absence – some 27 million days across 2022 – equates, on average, to around 74,500 full-time equivalent staff, including 20,400 nurses and 2,900 doctors. This is likely to be a significant underestimate due to various causes of under-recording of the sickness absence rate.
⦁ Over the course of 2022, some 6 million days were recorded for staff being sick due to mental health and wellbeing related reasons. The number of reported days of absences related to anxiety, stress, depression and other psychiatric illnesses increased by 26% between 2019 and 2022.
High sickness absence is bad for NHS staff, bad for providers of health care in terms of costs and disruption to patient care, and expensive for the taxpayer. Sickness absence is also associated with a higher likelihood of staff leaving the NHS. This briefing concludes that sickness absence will need to be adequately addressed as part of the NHS workforce long term plan.
The briefing can be found here.
For information
NHS Providers briefing: NHS Long Term Workforce Pan
On Friday 30 June 2023, NHS England (NHSE) published the long-awaited NHS Long Term Workforce Plan (LTWP). NHS Providers has been calling for a plan to place the NHS workforce on a sustainable footing for some time, often in coalition with other key stakeholders. The publication of the LTWP and its focus on training, retention and reform, is therefore a significant and welcome step.
This briefing outlines the key components of the plan and NHS Providers initial response.
For information
NHS Providers briefing on NHS Equality, Diversity and Inclusion improvement plan.
On Thursday 8 June 2023, NHS England (NHSE) published its first equality, diversity and inclusion (EDI) improvement plan. Developed in consultation with diverse staff, staff networks and stakeholders, NHS Providers contributed to this process as part of the working group. This briefing outlines the context of the plan and summarises the high impact actions and accountability framework shown below:
⦁ Chief executives, chairs and board members must have specific and measurable EDI objectives to which they will be individually and collectively accountable
⦁ Embed fair and inclusive recruitment processes and talent management strategies that target under-representation and lack of diversity.
⦁ Develop and implement an improvement plan to eliminate race, disability and gender pay gaps.
⦁ Develop and implement an improvement plan to address health inequalities within the workforce.
⦁ Implement a comprehensive induction, onboarding and development programme for internationally-recruited staff.
⦁ Create an environment that eliminates the conditions in which bullying, discrimination, harassment and physical violence at work occur.
For consideration and action by all NHS bodies
The King’s Fund report: How does the NHS compare to the health systems of other countries
Comparing the health care systems of different countries can help politicians and policy‑makers assess how the UK health care system is performing and where it could improve. For their research, the King’s Fund reviewed the academic literature on previous attempts to compare health care systems, analysed quantitative data on health system performance, and interviewed experts in comparative health policy. They found:
⦁ The UK health care system has fewer key resources than its peers. It performs relatively well on some measures of efficiency but waiting times for common procedures were ‘middle-of-the-pack’ before the Covid-19 pandemic and have deteriorated sharply since.
⦁ The UK performs well on protecting people from some of the financial costs of ill health, but lags behind its peers on important health care outcomes, including life expectancy and deaths. The latter could have been avoided through timely and effective health care, and public health and preventive services.
⦁ There is little evidence that one particular ‘type’ of health care system or model of health care funding produces systematically better results than another. Countries predominantly try to achieve better health outcomes by improving their existing model of health care, rather than by adopting a radically different model.
The report can be found here.
For information
Disclaimer: This briefing paper is intended to highlight recent developments and issues within the NHS that may be of interest to non-executive directors, lay advisers and NHS managers and teams working in the NHSE. It is not exhaustive, and TIAN cannot be held responsible for any omission.
